• Journal of Dairy Science and Biotechnology
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• v.22 no.1
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• pp.13-25
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• 2004

High concentration of cholesterol in the blood streams of humans has been recognized as a risk factor in the coronary heart disease. Recently, lactobacilli having high bile salt hydrolase activity have been claimed to decrease the concentration of the blood stream cholesterol in humans. In particular, many studies have been reported on the hypocholesterolemic effect of Lactobacillus acidophilus, a normal component of the microflora of the small intestine. Bile salts are excreted as bile into duodenum in the form of N-acyl compounds conjugated with glyine or taurine. Bile excretion is the major route of eliminating cholesterol from the body as well as one of the important pathways of cholesterol metabolism. Since conjugated bile salts are necessary to emulsify cholesterol, deconjugation of bile salts by lactobacilli could decrease intestinal absorption of cholesterol. Free bile salts as well as cholesterol are less soluble than the conjugated bile salts. Therefore, few free bile salts and cholesterol are absorbed through the enterohepatic circulation and most of them are easily excreted via feces. Thus, serum cholesterol could be removed from the body pool by synthesizing new conjugated bile salts to replace the excreted ones.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.33-42
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• 1979

The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.268-273
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• 1977

During the period from March, 1963, to November, 1977, forty-eight patients with secundum type atrial septal defects have undergone surgical repair using cardiopulmonary bypass with a pump oxygenator at the Seoul National University Hospital. Twenty-six [55 percent] of the patients were females and Twenty-two [45 percent] were males. The patients varied in age from 3 years to 51 years. We have divided secundum defects into three types. These are: 1] the high defect; 2] Ovale type defect; and 3] low defect including the defect in the area of the coronary sinus. An ovale type defect was present in forty-one cases [85 percent]. Partial anomalous pulmonary venous connections were present in two patients in the high defect group. All of the forty-eight patients had had right heart catheterization before operation. The pulmonary to systemic flow ratio [Qp/Qs] was determined in our 38 patients. The Qp/Qs was less than 1.5/1 in only five of the 38 patients. Among the 33 patients with moderate and severe left-to-right shunts [Qp/Qs 1.6-3.5/1], the systolic pulmonary artery pressures. ranged from 30 to 80 mm Hg. Large left-to-right shunts [Qp/Qs>3.6/1] were present in 13 patients. The postoperative complications occurred in 13 patients [27. 1 percent]. Postoperative wound infections were the most frequent complications being present in 6 patients [12.5%]. Forty-six of the patients with secundum atrial septal defects survived surgical repair of their defects. Thus the hospital mortality of surgery was 4.2 percent. The causes of death in the early postoperative period were: 1] low cardiac output syndrome related to severe pulmonary hypertension in one case; and 2] postoperative several bleeding in one case.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1040-1051
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• 1988

From 1959 through Jun. 1988, 2094 cases of various Cardiovascular diseases were operated, which were consisted of 1215 open heart surgery under extra-corporeal circulation or hypothermia and 879 conventional Cardiovascular Surgery at Department of Thoracic & Cardiovascular Surgery in National Medical Center. There were 1111 congenital heart anomalies and 983 acquired cardiovascular diseases. Among 1111 congenital cases, acyanotic cases were 748 and cyanotic cases were 363. In acquired heart cases, valvular heart diseases [702 cases] were the most frequent and a small No. of cardiac tumor and coronary artery diseases were included. Overall operative mortality was 9.3%, consisting of 4.6% for acyanotic anomaly, 20.6% for cyanotic anomaly and 8.7% for acquired heart diseases. In open heart surgery, overall mortality was 11.6% and 6% in conventional cardiovascular surgery.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.133-139
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• 1977

Two cases of congenital aneurysm of sinus of Valsalva, ruptured into the right ventricle, and associated with ventricular septal defects, were undergone intracardiac repair with the aid of extracorporeal circulation using Bentley bubble oxygenator and moderate hypothermia. Case 1. A 20 year old male, with the chief complaints of palpitation and dyspnea, was admitted to Kyungpook National University Hospital on Dec. 16, 1976. Continuous machinery murmur was heard best at left 3rd. intercostal space along the sternal border. Retrograde aortography disclosed aneurysm of the right coronary cusp, which ruptured into the right ventricle. Utilizing cardiac bypass and moderate hypothermia, the right ventricle was opened and aneurysm was closed by direct sutures. Associated ventricuar septal defect was directly ,closed and suture line was reinforced by Dacron patch. Total bypass time was 112 minutes and total aortic cross clamping time was 37 minutes. Assist ventilation was carried out for 28 hours postoperatively. His postoperative course was smooth except removal o1 substernal hematoma and he was .discharged on 24th postoperative day. Case 2. A 28 year old man was admitted to our Hospital on June 9, 1976. two weeks prior to this admission, suddenly he had collapsed while he was walking on the street. Following `this episode, palpitation, dyspnea on exertion and frequent respiratory infection developed. Grade IV systolic murmur was heard best at 3rd intercostal space along the sternal border. Retrograde aortography confirmed the diagnosis of rupture of aneurysm of the sinus Valsalva ruptured into the right ventricle. Under the cardiopulmonary bypass the right ventricle was opened and ruptured aneurysm and infracristal ventricular septal defect were directly closed and reinforced with Dacron patch. Postoperative course was uneventful and he was discharged on 14th postoperative day. The pathogenesis of aneurysm of the sinus Valsalva and mode of diagnosis were discussed. Principle of surgical repair was presented.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1118-1127
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• 1990

Arterial switch operation for repair of nineteen cases of transposition of the great arteries associated with ventricular septal defect and three cases with double outlet right ventricle with subpulmonary ventricular septal defect[Taussig-Bing type DORV] was performed from November 1987 to September 1990 at the Seoul National University Children`s Hospital. Sixteen of them were under six months of age, and three were under one year of age with body weight ranged from three to fourteen kilograms. Preoperative cardiac catheterization was done in eighteen patients, in which the pressure of the left ventricle was greater than 70% of the right ventricle in all but one. Patent ductus was associated in thirteen cases[68.4%] of TGA+VSD, and atrial septal defect or patent oval foramen was in sixteen cases. Four atrial septostomy, one modified Blalock- Taussig shunt, one pulmonary artery banding, one coarctoplasty using subclavian arterial flap, were perfomed before arterial switch operation. There were five hospital deaths, all in the. patients with transposition of the great arteries with ventricular septal defect[overall mortality rate 22.7%]. Lecompte Maneuver was used in all patients, and in all patient the U-shaped flap of coronary arteries were transposed to V-shaped cleavage created in the neoaorta. Arterial defect in the neopulmonary artery was covered with 0.0625% Glutaraldehyde fixed autogenous pericardium There have been no late deaths, Postoperative cardiac catheterization and angiocardiogram in four patients has revealed no stenosis in the neopulmonary artery or neoaorta with reasonable P[RV/LV], Anatomic correction for transposition and double outlet right ventricle with subpulmonary ventricular septal defect would seem to be a good operative alternative to intraatrial switch procedures, with the advantage of incorporating the left ventricle to systemic circulation.

• Molecules and Cells
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• v.27 no.3
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• pp.291-297
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• 2009

Apolipoprotein (apo) C-III is a marker protein of triacylglycerol (TG)-rich lipoproteins and high-density lipoproteins (HDL), and has been proposed as a risk factor of coronary heart disease. To compare the physiologic role of reconstituted HDL (rHDL) with or without apoC-III, we synthesized rHDL with molar ratios of apoA-I:apoC-III of 1:0, 1:0.5, 1:1, and 1:2. Increasing the apoC-III content in rHDL produced smaller rHDL particles with a lower number of apoA-I molecules. Furthermore, increasing the molar ratio of apoC-III in rHDL enhanced the surfactant-like properties and the ability to lyse dimyristoyl phosphatidylcholine. Furthermore, rHDL containing apoC-III was found to be more resistant to particle rearrangement in the presence of low-density lipoprotein (LDL) than rHDL that contained apoA-I alone. In addition, the lecithin:cholesterol acyltransferase (LCAT) activation ability was reduced as the apoC-III content of the rHDL increased; however, the CE transfer ability was not decreased by the increase of apoC-III. Finally, rHDL containing apoC-III aggravated the production of MDA in cell culture media, which led to increased cellular uptake of LDL. Thus, the addition of apoC-III to rHDL induced changes in the structural and functional properties of the rHDL, especially in particle size and rearrangement and LCAT activation. These alterations may lead to beneficial functions of HDL, which is involved in anti-atherogenic properties in the circulation.

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1115-1117
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• 1999

A persistent left superior vena cava draining into the coronary sinus is the most benign and widely encountered abnormality and can easily be explained embryologically as the persistence of the usual pattern of vnous circulation in the embryo,. However a persistent left superior vena cava draining into the left atrium with absent right superior vena cava is an extremely rare anomaly. We report this situation in an infant with tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium. In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot.

• Korean Circulation Journal
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• v.53 no.5
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• pp.331-343
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• 2023

Background and Objectives: The prognostic implication of right atrial (RA) and left atrial (LA) size for an immediate success of direct current cardioversion (DCCV) in atrial fibrillation (AF) remains unclear. This study aimed to compare RA and LA size for the prediction of DCCV success. Methods: Between 2012 and 2018, 734 consecutive outpatients were screened for our prospective registry. Each eligible patient received a medical history, blood analysis, and transthoracic echocardiography with a focus on indexed RA (iRA) area and LA volume (iLAV) prior to DCCV with up to three biphasic shocks (200-300-360 J) or additional administration of amiodarone or flecainide to restore sinus rhythm. Results: We enrolled 589 patients, and DCCV was in 89% (n=523) successful. Mean age was 68 ± 10 years, and 40% (n=234) had New York heart association class >II. A prevalence of the male sex (64%, n=376) and of persistent AF (86%, n=505) was observed. Although DCCV success was associated with female sex (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.06-3.65), with absence of coronary heart disease and normal left ventricular function (OR, 2.24; 95% CI, 1.26-4.25), with short AF duration (OR, 1.93; 95% CI, 1.05-4.04) in univariable regression, only iRA area remained a stable and independent predictor of DCCV success (OR, 0.27; 95% CI, 0.12-0.69; area under the curve 0.71), but not iLAV size (OR, 1.16; 95% CI, 1.05-1.56) in multivariable analysis. Conclusions: iRA area is superior to iLAV for the prediction of immediate DCCV success in AF.

• Korean Circulation Journal
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• v.53 no.4
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• pp.239-250
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• 2023

Background and Objectives: Brugada syndrome (BrS) is an inherited arrhythmia syndrome that presents as sudden cardiac death (SCD) without structural heart disease. One of the mechanisms of SCD has been suggested to be related to the uneven dispersion of transient outward potassium current (I_to) channels between the epicardium and endocardium, thus inducing ventricular tachyarrhythmia. Artemisinin is widely used as an antimalarial drug. Its antiarrhythmic effect, which includes suppression of I_to channels, has been previously reported. We investigated the effect of artemisinin on the suppression of electrocardiographic manifestations in a canine experimental model of BrS. Methods: Transmural pseudo-electrocardiograms and epicardial/endocardial transmembrane action potentials (APs) were recorded from coronary-perfused canine right ventricular wedge preparations (n=8). To mimic the BrS phenotypes, acetylcholine (3 μM), calcium channel blocker verapamil (1 μM), and I_to agonist NS5806 (6-10 μM) were used. Artemisinin (100-150 μM) was then perfused to ameliorate the ventricular tachyarrhythmia in the BrS models. Results: The provocation agents induced prominent J waves in all the models on the pseudo-electrocardiograms. The epicardial AP dome was attenuated. Ventricular tachyarrhythmia was induced in six out of 8 preparations. Artemisinin suppressed ventricular tachyarrhythmia in all 6 of these preparations and recovered the AP dome of the right ventricular epicardium in all preparations (n=8). J wave areas and epicardial notch indexes were also significantly decreased after artemisinin perfusion. Conclusions: Our findings suggest that artemisinin has an antiarrhythmic effect on wedge preparation models of BrS. It might work by inhibition of potassium channels including I_to channels, subsequently suppressing ventricular tachycardia/ventricular fibrillation.